Cosmetic Ear Surgery (Otoplasty)

Otoplasty is an operation designed to bring the ears closer to the side of the head and improve contour. This surgery is most common with school age children experiencing teasing. This procedure can produce a great result and relief for a child. However, it is not limited to children, adults are also candidates.

An otoplasty creates several changes in the ear. They all look natural. It is unlikely that someone unaware of the surgery would think that your ear had been surgically altered. These changes can include: 1) A less prominent earlobe, 2) A flatter concha (the cup-like area surrounding the ear canal where sutures are placed in the cartilage to flatten it), or 3) a more shallow sulcus (the normal groove behind the ear is known as the postauricular or retroauricular sulcus. This change may affect the way your glasses fit).

The Procedure

The primary incision is placed behind the ear where it is very unnoticeable. Sutures are then placed along the cartilage of the ear. This makes the cup portion of the ear shallower and causes the ear to lie closer to the head. These are permanent sutures that remain under the overlying skin. The shape of the ear can also be changed by surgically weakening the cartilage in strategic areas. Following this shaping, any excess skin is removed. The skin is closed with removable sutures and a head dressing is applied. Gauze fluffs are placed around the ear to protect it and the head is wrapped in a turban fashion. General anesthesia is most effective for young children. Older, cooperative children, and adults can have this procedure with local anesthesia or IV sedation. This is commonly done as an outpatient procedure.

Recovery

The day after surgery the head dressing is removed to check the surgical site. Various dressing will be used for one or two weeks. If you prefer, you can be instructed in this and change the dressing daily on your own. At two weeks, normal daily activities are resumed however contact sports are to be avoided for three months. The ears can be wrapped at night for comfort. In the first few days, the ears will be swollen and tender. Because of the swelling it is hard to appreciate the results. These post operative symptoms resolve within a few weeks. You may experience numbness and tingling of the ears for several weeks. Within a few weeks the ears will look quite normal.

Complications are infrequent and usually minor. Nevertheless, as with any operation, there are risks associated with surgery and specific complications associated with this procedure. A small percentage of patients may develop a blood clot on the ear. It may dissolve naturally or can be drawn out with a needle. Occasionally, patients develop an infection in the cartilage, which can cause scar tissue to form. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area.

Most patients, young and old alike, are thrilled with the results of ear surgery. But keep in mind, the goal is improvement, not perfection. Don’t expect both ears to match perfectly. Perfect symmetry is both unlikely and unnatural in ears. If you’ve discussed the procedure and your expectations with the surgeon before the operation, chances are, you’ll be quite pleased with the result.